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亚急性甲状腺炎患者中甲状腺乳头状癌的患病率可能高于预期:137 例患者的回顾性分析。

Prevalence of papillary thyroid cancer in subacute thyroiditis patients may be higher than it is presumed: retrospective analysis of 137 patients.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

出版信息

Radiol Oncol. 2018 Sep 11;52(3):257-262. doi: 10.2478/raon-2018-0027.

Abstract

Background The association of subacute thyroiditis (SAT) and papillary thyroid carcinoma is a rare finding. In this study, we aimed to investigate the prevalence of differentiated thyroid cancer in a cohort of patients followed with the diagnosis of SAT. Patients and methods We retrospectively screened medical records of Endocrinology and Metabolism outpatient clinic in the past 20 years for patients with SAT. Patients with nodules and suspicious ultrasonography findings who underwent fine needle aspiration biopsy (FNAB) and operated due to malignancy risk were identified. Results We identified 137 (100 females, 37 males) patients with reliable records to confirm the diagnosis of SAT. The mean age of female patients was 41.1 ± 9.1 (range, 20-64) and of male patients was 43.0 ± 9.3 (range, 20-65). One or more FNAB was performed in 23 of the patients (16.8%) at the beginning and/or during the follow-up period when needed. Seven patients with suspicious FNAB findings were operated, and histopathological examination of the nodules confirmed the diagnosis of papillary thyroid carcinoma in 6 patients (4.4%). Conclusions Our observations suggesting a relatively higher prevalence of thyroid cancer in a small series of SAT patients warrant further studies to identify the real frequency of differentiated thyroid cancer and its association with inflammatory pathogenesis of SAT. This finding is compatible with the trend of increased thyroid cancer incidence all over the world. A repeat ultrasonography after resolution of clinical and inflammatory findings, and FNAB should be recommended to all patients with suspicious nodules.

摘要

背景

亚急性甲状腺炎(SAT)与甲状腺乳头状癌相关是一种罕见的发现。本研究旨在探讨 SAT 患者队列中分化型甲状腺癌的患病率。

方法

我们回顾性筛选了过去 20 年来内分泌和代谢门诊的病历,以确定 SAT 患者。对有结节和可疑超声表现的患者进行细针穿刺活检(FNAB),并根据恶性风险进行手术。

结果

我们确定了 137 例(100 名女性,37 名男性)具有可靠记录以确诊 SAT 的患者。女性患者的平均年龄为 41.1 ± 9.1(范围,20-64),男性患者的平均年龄为 43.0 ± 9.3(范围,20-65)。在需要时,有 23 例患者(16.8%)在开始和/或随访期间进行了一次或多次 FNAB。7 例可疑 FNAB 结果的患者接受了手术,结节的组织病理学检查在 6 例患者(4.4%)中证实了甲状腺乳头状癌的诊断。

结论

我们的观察结果表明,在一小部分 SAT 患者中,甲状腺癌的患病率相对较高,需要进一步研究以确定分化型甲状腺癌的真实频率及其与 SAT 炎症发病机制的关系。这一发现与全球范围内甲状腺癌发病率增加的趋势一致。对于所有有可疑结节的患者,在临床和炎症表现缓解后应推荐重复超声检查和 FNAB。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a7/6137358/d4cf8cc7ffa9/raon-52-257-g001.jpg

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